Botox bars raise concern among medical experts: "Things can happen"

Nearly 16 million minimally invasive cosmetic procedures took place last year in the United States. That includes nearly 7.5 million injections of Botox and other neurotoxins to reduce wrinkles, and more than 2.5 million filler injections to shape the face. These enhancements traditionally require a visit to a doctor's office -- but new salons are offering injections in a more casual setting, raising fears of potential risks.    

These spas, called the "dry bars of Botox," focus on anti-aging injectables, which are designed to be more convenient and less clinical than a doctor's visit. And while it's legal for non-physicians, like nurses, to administer these products, professionals said these procedures carry serious risks.

Kaitlyn Doyle gets regular Botox injections at Alchemy 43, a nationwide chain that offers non-surgical procedures like Botox and fillers in a casual setting similar to a hair or nail salon.

"I don't think that we should feel like we're in a clinical, cold environment…" Doyle said. "It's self care, and it should almost be something enjoyable and fun." 

While social media inspires many Americans to seek out cosmetic procedures, it's also filled with customer reviews of various companies showing the damage that can be done.

"Fortunately, the vast majority of the time in any setting, these are safe, and they're done properly," said Dr. Alan Matarasso, president of the American Society of Plastic Surgeons. "But the public needs to realize that this is medical care and things can happen with medical care."  

"With injections, you can lose skin, you can get gangrene, you can get blindness that requires moments to treat," Matarasso added.

Injectables must be ordered by doctors, and many states require facilities to have medical directors.  But those doctors aren't necessarily plastic surgeons or dermatologists, and they aren't always on site.

That's a risk Sherry -- who asked CBS News not to use her last name – didn't know about when she got Botox and filler last year.

"I just wanted a little lift, a little tweaking," she said.

Sherry didn't go to a storefront Botox bar like Alchemy 43; instead, she had the procedures done at a private nurse practitioner's office.  Within minutes, she knew something was wrong.

"I'm looking in the mirror and I think I'm turning purple," she said.
 
The filler had been injected into a blood vessel. Sherry said the clinic's medical director was 40 minutes away, and was giving instructions to the nurse practitioner on the phone.

"She's taking pictures and texting them to him," she said. 

Hours later, the doctor arrived with the medicine that could un-block blood flow to the area around her nose.

"The only thing I remember him saying is, 'You're lucky you didn't lose your nose,' which was quite alarming," she recalled.  

Even after oxygen therapy, Sherry was left with damaged blood vessels, skin discoloration and severe headaches.  

"Every morning, I have to look at myself and I see it, and it's also a constant reminder of what I went through," she said.

Dr. Ramtin Kassir treated Sherry after her filler complication. "Injecting in the face […] could be dangerous, because if you get into any of these blood vessels, it can end in the eye, it can end in the forehead, it can end in the nose," Kassir said.

While even the most experienced doctor can hit a blood vessel, Kassir said it's critical to have filler-dissolving medicine at arm's reach.

"We preload it into these syringes," he said. "So I don't even have to stop and draw it out."

Alchemy 43 founder Nicci Levy said her staff is prepared for emergencies. "You are getting a needle in your face," she said. "There is some risk attached to that. And we certainly don't take that lightly."

"We've been very diligent about training them on that," Levy added. "And we also keep all the materials here that are needed in case we did need to address something immediately."   

The risks don't seem to bother Doyle. After her injections, she said she felt "fantastic."

"I cannot wait for the next week to see the full results," she said. "But it was quick, it was painless -- so just goes to show, beauty isn't always pain."

Procedures at these retail outlets typically cost several hundred dollars apiece. They can be slightly less expensive than going to a doctor's office, and some even offer discounts for frequent visits.